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| 22KS-025 |
Safety Profile of Ultrasound-Guided Rectus Sheath Blocks: A Retrospective Analysis of 4033 Injections
1Department of Anesthesiology and Pain Medicine, Asan
Medical Center, University of Ulsan College of Medicine, Seoul, Republic of
Korea
Background: Although ultrasound guided rectus sheath block is usually regarded as an easy and safe procedure in clinical settings, there is still no safety profile reported till date. Therefore, the present study aimed to investigate complications in a large cohort and describe the technical considerations for a safety ensured real-time ultrasound-guided rectus sheath block.
Methods: Data and ultrasound images of patients who underwent real-time ultrasound guided rectus sheath block for perioperative pain control in laparoscopic abdominal surgery with midline laparotomy were reviewed and collected from the electronic medical record system retrospectively. Patients with poor quality of ultrasound image or incomplete data were excluded from the study. The data including demographics, preoperative laboratory data, preoperative antiplatelet or anticoagulant medication with duration of discontinuation, type of surgery, and adverse events of rectus sheath block were analyzed accordingly.
Results: A total of 96 complications (2.4%) were observed for the 4033 procedures. Among them, extra-rectus sheath injection occurred in 88 cases (2.2%), which included preperitoneal injection (0.9%) and intraperitoneal injection (1.3%). Vascular injuries constituted eight cases (0.2%) including seven cases of inferior epigastric artery injury with rectus sheath hematoma and one case of inferior mesenteric artery injury with intraperitoneal hematoma. Bowel injury or local anesthetic systemic toxicity were not reported.
Conclusions: Although real-time ultrasound-guided rectus sheath block is considered a safe procedure, serious complications can occur in patients. Therefore, care should be taken in order to perform a safety ensured procedure.
Methods: Data and ultrasound images of patients who underwent real-time ultrasound guided rectus sheath block for perioperative pain control in laparoscopic abdominal surgery with midline laparotomy were reviewed and collected from the electronic medical record system retrospectively. Patients with poor quality of ultrasound image or incomplete data were excluded from the study. The data including demographics, preoperative laboratory data, preoperative antiplatelet or anticoagulant medication with duration of discontinuation, type of surgery, and adverse events of rectus sheath block were analyzed accordingly.
Results: A total of 96 complications (2.4%) were observed for the 4033 procedures. Among them, extra-rectus sheath injection occurred in 88 cases (2.2%), which included preperitoneal injection (0.9%) and intraperitoneal injection (1.3%). Vascular injuries constituted eight cases (0.2%) including seven cases of inferior epigastric artery injury with rectus sheath hematoma and one case of inferior mesenteric artery injury with intraperitoneal hematoma. Bowel injury or local anesthetic systemic toxicity were not reported.
Conclusions: Although real-time ultrasound-guided rectus sheath block is considered a safe procedure, serious complications can occur in patients. Therefore, care should be taken in order to perform a safety ensured procedure.